Staying consistent with medications, lab monitoring, and routine clinic follow-up is essential to maintaining transplant health. As adolescents mature, they build independence by understanding their routines, recognizing barriers, and developing strategies to stay on track. This section supports strengthening adherence through practical interventions, communication, transparency, and shared responsibility.
Supporting Medication Adherence for Transition-Age Youth
Emphasize the importance of adherence with transition-age youth.
- Adopt a patient-centered approach. It is important to develop a medication therapy plan in collaboration with the AYA that maintains their transplant health but also promotes success. Discuss their routine and how medications can easily fit into their daily schedule and activities. Minimize administration times when possible (i.e., daily or twice daily dosages).
- Develop a collaborative monitoring plan with the AYA.
- How many doses do you think you miss in a week?
- When are doses most often missed or late (mostly morning or evening doses; weekends)?
- What most commonly interferes with your ability to take your medications daily and on time?
- Discuss the AYA’s current level of responsibility for taking medications. Have them describe how they are taking their medications and the level of parental involvement (administering meds, reminding only, checking only). Confirm when the AYA is completely independent in taking medications and confirm this with their parent/caregiver to get their perspective.
- The AYA should understand the process and be able to take responsibility for ordering refills as they approach transfer in late adolescence.
- Ask the AYA to describe their medication routine and any tools that are being used (phone apps, alarms, pillbox, medication list).
- Formulate a plan with the AYA for whom to call if they are having problems obtaining their prescribed medications (pharmacy issues, insurance coverage, transportation, finances)?
- Ask the AYA about any perceived barriers they may encounter when getting labs, ordering medications, communicating with their coordinator, or attending clinic as requested.
AYAs with intellectual disabilities and comorbid psychiatric conditions may benefit from having support people educated in their care. Patients with socioeconomic constraints (i.e., financial, transportation, family support) will likely need additional resources to successfully engage in care. Members of the multidisciplinary team including social work, psychology/psychiatry, nursing and pharmacy can assist in developing individually tailored plans for AYAs with special considerations. See this AST site for addition information: TRAMM (Transplant Recipient Adherence Monitoring and Management Tool).
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